Ch. 39 Oxygenation and Perfusion FOUNDATIONS

The following formula is used to determine cardiac output: Cardiac Output = Stroke Volume x Heart Rate.

A client with a stroke volume of 50 mL and heart rate of 50 beats per minute has a cardiac output of 2.5 L/minute. If stroke volume is 70 and heart rate is 70 beats per minute, then the cardiac output is 4.9 L/minute. If stroke volume is 80 and heart rate is 80 beats per minute, then the cardiac output is 6.4 L/minute.

Bronchitis caused by:

Commonly due to respiratory irritants such as air pollution and high humidity; release of inflammatory mediators, which in turn, lead to inflammation and narrowing of the airways and increased mucus production

The nurse auscultates a client with *soft, high-pitched popping breath sounds on inspiration*

Crackles

An older adult client visits a health care facility for a scheduled physical assessment. During the assessment, the client reports difficulty breathing. Which suggestion could the nurse make to improve the client's respiratory function?

Drink liberal amounts of fluid *keeps mucous membranes moist*

A nurse is caring for a client who breathes *very shallowly and has been reporting severe back pain*. What suggestion could the nurse make to help the client breathe efficiently?

Encourage the client to take deep breaths

The nurse is caring for a client who is diagnosed with Impaired Gas Exchange. While performing a physical assessment of the client, which data is the nurse likely to find?

High Respiratory Rate *this is a compensation measure*

To drain the *apical* sections of the upper lobes of the lungs, the nurse should place the client in which position?

High-Fowlers

What intervention prevents postoperative pneumonia and atelectasis during this time of reduced mobility following surgery?

Incentive Spirometry

Which teaching about the humidifier is important for the nurse to provide to a client using oxygen?

It decreases dry mucous membranes via delivering small water droplets.

The nurse is suctioning a client's tracheostomy when the tracheostomy becomes dislodged and the nurse is unable to replace it easily. What is the nurse's most appropriate response?

Maintain the client's oxygenation and alert the health care provider immediately

A client's primary care provider has informed the nurse that the client will require thoracentesis. The nurse should suspect that the client has developed which disorder of lung function?

Pleural Effusion

What intervention address dyspnea (common with COPD) and anxiety?

Pursed lip breathing

A client vomits as a nurse is inserting his oropharyngeal airway. What would be the most appropriate intervention in this situation?

Remove the airway, turn the client to the side, and provide mouth suction, if necessary

What position assists in draining the lower lobes of the lungs?

Trendelenburg

After insertion of a chest tube, fluctuations in the water-seal chamber that correspond with inspiration and expiration are an expected and normal finding (True or False)

True

A child is stung by a bee and develops wheezing in the upper airways. The child is experiencing:

bronchospasm

Bronchiectasis caused by:

chronic inflammation or infection causing an excess accumulation of mucus.

The nurse has received a prescription to obtain an arterial blood gas (ABG) on a client who has a history of chronic obstructive pulmonary disease (COPD) and is receiving oxygen via nasal cannula. Which step is the most important for the nurse to fulfill?

ensure client is at rest at least 30 minutes before obtaining the specimen -then apply pressure 5-10 minutes after collection -then transport specimen on ice

Bronchial Sounds

loud, high-pitched sounds heard primarily over the trachea and larynx

Vesicular Sounds

low-pitched, soft sounds heard over peripheral lung fields

Bronchovesicular Sounds

medium-pitched blowing sounds heard over the major bronchi

A nurse must deliver oxygen at a concentration of 85% to an *infant* Which delivery device would be *most appropriate for an infant*?

oxygen hood

Atelectasis caused by:

partial or complete collapse of the small air sacs in the lungs, common after surgery or with obstruction or compression of the airways or lungs

Conditions causing decreased fremitus:

pleural effusion, pulmonary edema, emphysema, pneumothorax, bronchial obstruction and left-sided heart failure (results in pulmonary edema)

Placing the client in a side-lying position, half on the abdomen and half on the side, right and left, helps to drain:

posterior sections of the upper lobes of the lungs

The client asks, "Why is it important to start by breathing through my nose, then exhaling through my mouth?" Which appropriate response would the nurse give this client?

"Breathing through your nose first will warm, filter, and humidify the air you are breathing."

The nurse has applied supplementary oxygen by nasal cannula, recognizing that the flow rate by this method should not exceed:

6 L/minute.

The nurse is providing an educational demonstration to an older, postsurgical client. The intervention is intended to minimize the effect of what age-related change specifically relevant to such a client?

A decrease in ventilation and an ineffective cough related less air exchange, more excretions remaining in the lungs *cough is important after surgery to expulse secretions and prevent pneumonia*

Fremitus

vibration of air movement through the chest wall *It is best felt by placing the balls of the palms of your hand on the client's back as the client says "99."*